Methods for treating degenerative disc disease and chronic lower back pain

Abstract

The present invention in various aspects and embodiments provides methods for the treatment or prevention of degenerative disc disease or chronic lower back pain.

The invention claimed is: 
     
       1. A method for treating degenerative disc disease or chronic lower back pain, comprising: administering to a patient having degenerative disc disease or chronic lower back pain, and suspected of having a low-virulence infection, an antibiotic and an inhibitor of Nerve Growth Factor (NGF), wherein the inhibitor of NGF is tanezumab, fulranumab, TrkAd5, AMG 403, Appha-D11, MNAC13, ALE0540, PD90780, or PPC-1807. 
     
     
       2. The method of  claim 1 , wherein the patient is suspected of having a low-virulence infection based on the detection of a commensal pathogen in intervertebral disc tissue. 
     
     
       3. The method of  claim 2 , wherein the presence of the commensal pathogen is detected in intervertebral disc tissue by one or more of: the presence of microbial nucleic acid, host cell RNA profile, immunohistochemistry of disc tissue, and microbial-specific staining of disc tissue. 
     
     
       4. The method of  claim 3 , wherein the commensal pathogen is one or more of  Propionibacterium  sp.,  Staphylococcus  sp.,  Corynebacterium  sp.,  Lactobacillus  sp.,  Pseudomonas  sp.,  Enterococcus  sp.,  Streptococcus  sp.,  Bacillus  sp.,  Citrobacter  sp.,  E. coli, Moraxella  sp.,  Haemophilus  sp.,  Neisseria  sp.,  Clostridium  sp.,  Enterobacter  sp., and  Klebsiella  sp. 
     
     
       5. The method of  claim 4 , wherein the commensal pathogen is  Propionibacterium acnes.    
     
     
       6. The method of  claim 5 , wherein the low-virulence infection is identified by the presence of one or more virulence factors in the patient's disc tissue. 
     
     
       7. The method of  claim 1 , wherein the antibiotic is selected from benzylpenicillin, amoxicillin, ampicillin, dicloxacillin, methicillin, nafcillin, oxacillin, penicillin G, cephalexin, cefoxitin, cephalolothin, ceftriaxone, ciprofloxacin, chloramphenicol, erythromycin, tetracycline, vancomycin, clindamycin, fusidic acid, doxycycline, moxifloxacin, linezolid, rifampicin, ertapenem, taurolidine, or a combination thereof. 
     
     
       8. The method of  claim 1 , wherein the antibiotic is administered systemically or locally. 
     
     
       9. The method of  claim 8 , wherein the antibiotic is administered by a route selected from oral, parenteral, and transdermal. 
     
     
       10. The method of  claim 1 , wherein the inhibitor of NGF is administered by a route selected from parenteral, oral, and transdermal. 
     
     
       11. The method of  claim 10 , wherein the parenteral administration is subcutaneous injection, intramuscular injection, intravenous injection, or local injection to intervertebral disc tissue. 
     
     
       12. The method of  claim 1 , wherein antibiotic, and the inhibitor of Nerve Growth Factor (NGF) are co-administered. 
     
     
       13. The method of  claim 1 , wherein the antibiotic, and inhibitor of Nerve Growth Factor (NGF) are administered prior to surgery. 
     
     
       14. The method of  claim 1 , wherein the antibiotic, and inhibitor of Nerve Growth Factor (NGF) are administered following surgery.